What separates the Knee Clinic from the public system?
Our facility is the only private Knee Clinic in Alberta and is not affiliated with any public knee clinic initiatives. We offer timely assessment, diagnosis and treatment as well as specialist expertise that patients may otherwise only have access to after a very lengthy wait time in the public system. At the Knee Clinic, we believe that collaboration is of paramount importance to good clinical outcomes. We are a one stop shop for many patients and all of our practitioners work hard to communicate with each other as well as with the rest of your health care team. Whether you need an assessment with one of our specialists, an image guided injection or hands on treatment by one of our other doctors or therapists, you can be sure you are seeing a practitioner who is up to date on your case and knows what is treatment is best suited to you. Finally, and perhaps most important of all, at the Knee Clinic we take the time to really listen and then clearly communicate the diagnosis and treatment plan to our patients in a way that is relevant and easy to understand.
What can the Knee Clinic do for me?
- Timely assessment and diagnosis by a specialist
- Direct surgical referrals via the public or private health care systems
- Advanced imaging requisition and consultation through either public or private streams (MRI, CT, Diagnostic Ultrasound, or any other imaging)
- Custom knee brace and orthotic prescription, acquisition and fitment
- Knee joint injection referrals and administration (Monovisc, Hyaluronic acid, Platelet-rich Plasma, Cortisone, Prolotherapy, Ozone, Cingal)
- Rehabilitation (both pre- and post-operative as well as non-operative)
- Physiotherapy, Chiropractic, Registered Massage Therapy, Acupuncture, IMS, Naturopathic Medicine
- Clear communication with your family physician and other members of your health care team
Who can receive care the Knee Clinic?
We do not discriminate against chronic injury or osteoarthritis. Individuals of all ages and activity levels are welcome at the Knee Clinic. From acute injuries or tears to chronic arthritis pain, or overuse injuries that plague both elite and recreational athletes, we can help!
Not a knee injury? Our practitioners are exceptionally well trained to assess and manage a variety of musculoskeletal ailments and would be happy to address these with you. Often a sore knee can be the result of compensation for another problem in the foot, ankle, hip, pelvis or lower back.
Who will I see?
Because our facility maintains a high quality and standard of healthcare provision, all of our practitioners are exceptionally well trained in their respective fields of expertise. Our specialists have completed extensive post-doctoral training and hold active Fellowship status in sports sciences and physical and occupational rehabilitation.
What do I need to bring with me?
Please ensure that your intake forms have been completed prior to your scheduled appointment time. These can be found on our website here or can be emailed to you upon request. If you wish to complete these forms on site, please arrive at least 10 minutes early. We also recommend that you wear loose fitting clothing or bring a pair of shorts with you.
Do I need to have had an X-ray or MRI prior to my appointment?
The short answer is no. We are good at what we do and a thorough history and clinical exam is usually sufficient to arrive at an accurate diagnosis and plan of management. However, if we feel that further imaging may be helpful, we can facilitate this for you through either the public or private system at the patient’s discretion.
Do I need a referral from a doctor?
No, you do not require a referral to see us!
How much does it cost for an initial assessment and what can I expect during this visit?
There are multiple ports of entry to the Knee Clinic and initial fees can vary, however, the initial assessment fee with one of our specialists is $450. This appointment is typically 50 -60 minutes in duration and you can expect the doctor to conduct a thorough history and clinical examination, as well as review any relevant diagnostic imaging with you. You will leave with an accurate diagnosis and plan of management, including treatment options and associated costs.
What if I need surgery?
In many cases, surgery should be viewed as a last resort, however, if after careful consideration it is deemed the most efficacious option, our clinic can facilitate a direct referral to the surgeon’s office for you. We maintain close ties with both public and private surgeons here and abroad.
Will my insurance plan cover the cost of my appointment?
This will depend on the details of your individual plan. Our specialists have received their base training as chiropractors, with extensive specialist training in the years beyond. They have attained post-doctoral fellowship status in sports sciences as well as physical and occupational rehabilitation.
As most people have chiropractic coverage it is convenient to be able to submit a claim for their initial assessment accordingly.
What are some ways to measure improvement?
WAYS TO MEASURE IMPROVEMENT
When a patient presents to our office with a complaint, it usually pertains to a change in their ability to function normally without pain. Pain is a multifaceted complaint that can be very complicated to manage. After a thorough history, physical examination and review of any pertinent imaging findings, our doctors are mandated to determine a working diagnosis. With that diagnosis comes a proposed plan of management that will require the patient to take an active role in their health care. The responsibility is a shared one between doctor and patient, and it is very important for the patient to follow through with their role during this plan of management, so that both doctor and patient are doing their part to create an optimal outcome for the patient.
Having appropriate expectations from the outset is very important and this is no more true than when talking about expectations of pain reduction or management. At both Elite Sport Performance and the Knee Clinic, our intake forms include what is known as a Visual Analog Scale for pain, allowing the patient to rate their subjective symptoms before the onset of treatment on a scale of 1 through 10. We also look at patient-reported outcome measures. This well validated approach looks at a person’s opinion of their pain and functionality and can include many different potential surveys. In our Private Knee Clinic, we utilize one such patient-reported outcome measure known as the Knee Injury and Osteoarthritis Outcome score (KOOS). Administering this survey, both before the onset of treatment and again at the conclusion of our clinical trial, allows us to get a better idea of the patient’s opinion of their own progress. There is often a disconnect, especially in the early phases of care, between subjective improvement and objective improvement. On each visit, our doctors or therapists will go through a series of objective tests and will compare the results of those tests to the previous treatment, as well as to the results from the initial assessment. Often, these findings will not match perfectly with the patient’s subjective experience of pain. This discrepancy lends itself to an important conversation about ways to measure improvement.
There are indeed many ways to measure improvement. Not only is the amount of pain important but so too is the length of time it takes for the patient’s painful symptoms to onset, the duration of symptoms, the activity level that they are able to maintain with an acceptable level of pain, and even how long it takes for them to recover after an activity.
The sport specialist nature of Elite Sport Performance is such that our mandate is to help patients continue participating in the sports or activities that they are passionate about. These patients typically understand that their pain symptoms may not go away completely during these activities but that being able to continue doing the activities even with a mild to moderate amount of discomfort is a victory unto itself. Other ways to measure improvement include a patient’s ability to sleep through the night, thereby allowing their body’s own restorative processes to help them heal further, or a patient’s ability to functionally perform their day to day tasks (such as brushing their hair) without significant pain.
Our ultimate objective is, of course, to have the patient’s pain go away and to have their function improve to the point that they are no longer thinking of or are even aware of their original presenting complaint. As the law of diminishing return suggests, the largest improvements are often made early on in the course of therapy. As time and treatment progresses, it is important for the patient to maintain consistency, both with their treatment as well as with their prescribed exercises and any changes or modifications to offending activities. With persistence and attention to these details, optimal therapeutic improvement can be reached.
Lastly, it is imperative for the patient to pay attention to what symptoms they experience from day-to-day and with different activities so that they can relay this back to the doctor or therapist. Let our doctors or therapists know of any pain medications that you may be taking because these can often mask the patient’s true symptoms.
Our brand promises at Elite Sport Performance are ‘Results, Clarity, and Collaboration’. If you have a musculoskeletal ailment and would like our expert input, please do not hesitate to contact us at (403) 689-9889 or by emailing us at [email protected].
What doctor should you see for knee pain?
If you have knee pain and are considering seeing somebody, make sure that it is somebody who has adequate training in assessment and diagnosis of musculoskeletal and orthopedic injuries. Family doctors, while excellent at keeping you alive, are not extensively trained in musculoskeletal or joint issues. It would, therefore, be more prudent to try to see a specialist early on in your course of knee pain.
What is a knee specialist called?
Generally, knee specialists are called doctors, but they can come in many different formats. In North America, there are medical specialties such as orthopedic surgeons, physiatrists or rheumatologists, or even sport medicine physicians who are all quite adept at dealing with knee issues. But medical physicians are not the only ones trained in this. Chiropractors have a remarkably extensive amount of training in musculoskeletal and orthopedic injuries and are often a good resource for people suffering from knee pain. Physiotherapists can also take additional training to become particularly adept with these cases. In Canada, osteopaths are not a regulated health profession and although in various parts of the world, osteopaths have excellent training, here they are limited to acting as osteopathic manual therapists without the ability to legally diagnose a knee condition.
When should I go to the doctor for a knee injury?
The simple answer here is that you should see a doctor for a knee injury when it begins to interfere with your activities of daily living. Additional answers include the presence of sharp pain or limping, as these help to differentiate between hurt and harm. It is not uncommon for a joint, including a knee, to be sore but if it begins to impact how you can proceed through your day-to-day life, the risk of this creating harm increases.
How long should knee pain last?
The typical inflammatory cycle for an acute injury is approximately 6 to 8 weeks. Most cases of knee pain will subside within this time frame. If your pain continues beyond this or if it interferes with your ability to perform day-to-day activities, you should consider seeing a knee specialist.
Can knee pain go away?
Often it does and all doctors will rely on the natural healing abilities of your body to help problems such as knee pain go away over time.
What causes knee pain without injury?
There are several factors that can contribute to knee pain in the absence of an actual injury. The most common ones include faulty lower limb mechanics ranging from a foot or ankle complaint all the way up to a hip or pelvic complaint. Repetitive strain injuries are also often responsible for knee pain without injury. Both repetitive strain injuries and faulty mechanics are related to inadequate muscular strength or inappropriate balance of muscle strength.
How are knee procedure performed?
Knee procedures are performed very carefully after the completion of a very thorough history, physical examination specific to the musculoskeletal aspects of your knee, and review of any pertinent diagnostic imaging. It is important that the doctor collaborate with you to develop a plan of management that is reasonable and that you can take an active role in participating in.
In what cases are knee procedures necessary?
Knee procedures are necessary most often when a knee complaint is impacting your ability to perform your activities of daily living. As soon as we begin to limp due to a knee issue, we start to create compensatory issues further up and down the biomechanical chain, often resulting in hip pain, lower back pain and even foot and ankle discomfort.
What are common knee procedures?
There is a wide range of knee procedures available for patients. These range from very conservative on to progressively more invasive. Some of the most common procedures performed within our clinic include custom exercise prescription from a physiotherapist, hands-on physiotherapy treatment, mobilization, myofascial release techniques, dry needling, custom knee bracing and on and on. Taping the knee can, on occasion, be helpful, sometimes image-guided joint injections are required, and certainly, we have the capacity to send for any type of diagnostic imaging that may be necessary and can coordinate surgical referrals when appropriate.
What are the causes of knee pain?
There are so many potential causes for knee pain that it would and does, in fact, fill textbooks. Some of the most common causes include faulty mechanics, repetitive strain injuries, which are defined as doing anything for too long, too hard, or without enough rest. Traumatic events can also contribute to knee pain but so too can, less commonly, infection autoimmune disorders or inflammation secondary to an injury.
What are risk factors for knee pain?
Many risk factors exist for knee pain. Some of the most common include high impact activities, plant and twist manoeuvres, and autoimmune disorders. The most common risk factor, however, for knee pain is generalized muscle weakness. If the global population did nothing other than work hard at building muscular strength, joint issues and indeed medical practices would be far less prevalent.
How can the Knee Clinic in Alberta help alleviate my knee pain?
We are the only private Knee Clinic in Alberta. Our approach to knee issues includes three pillars of care. The first pillar is to treat the actual problem. In our modern times, we have all of the diagnostic resources available to make sure that we know exactly what the problem is with your knee. There is no need for guesswork anymore. The second pillar involves strengthening the area. Creating three-dimensional stability around a knee helps to ensure that movement within the joint is controlled and closer to normal. This improved stabilization through strengthening almost always will result in less pain. A third pillar in our approach to care involves the avoidance or modification of offending activities. We are what we repeatedly do, and if there is a particular motion in our day-to-day lives that is contributing to our knee pain, it behooves us to try to modify or avoid that particular motion.
Can I avoid knee surgery?
Often, knee surgery can be avoided. Only a small proportion of knee injuries actually require surgical intervention. This proportion continues to decrease as research comes out on various conservative approaches as well as on surgical interventions. Surgical procedures are being refined every year and researchers are helping to isolate cases that are most appropriate for surgical intervention. A good example of this is the common meniscal tear. Several studies in the last 15 years have strongly shown that meniscal debridement procedures do not have a particularly high success rate. Approaching these injuries from a non-surgical perspective often results in at least an equal if not superior mid to long-term outcome.
Is knee pain prevalent among runners?
It certainly is but surprisingly, it is not much more prevalent than in the general population. This is largely because runners are typically more fit than the average person, maintain a healthier body weight than the average person, and have generally very good lower limb muscular strength. Runners suffer knee pain and injury from different causes, most commonly repetitive strain. Running is very much a front-to-back based activity, meaning that certain muscles including your quadricep and hamstring, become disproportionately strong. If a runner does not take care to cross train and work specifically on lateral strengthening for both groin and lateral pelvic muscles, their risk of suffering knee pain and injury increases.
Is it normal for my knee to hurt after playing basketball?
Knee pain after basketball is certainly not normal but it is common. One of the principle factors in this is the very low profile, high grip court shoe that basketball players wear. There is very little shock absorption in a shoe like this and consequently, shock waves travel into the foot through the ankle, up the shin, and into the medial part of the knee to a greater extent than in other activities. Basketball also involves sudden starts and stops as well as many plant and shift manoeuvres or plant and twist manoeuvres, and these have a disproportionately high risk of creating knee pain and injury.
How do I know if I need a knee replacement?
In Calgary, knee replacements are typically done as total knee arthroplasties. This is to say a complete knee replacement. Unicompartmental or partial knee replacements seem to be falling slowly out of favour in Calgary. You will know you need a knee replacement only after a thorough consultation with a knee specialist, as well as after you have exhausted all conservative options. It is important to realize that there is a broad spectrum of intervention options available for knee injuries or knee osteoarthritis, beginning with the most conservative option and progressing on as more conservative options fail will lead you slowly but knowledgeably towards a knee replacement.
How do you treat a knee injury?
Knee injuries have to be treated very specifically with a focus on individualized care specific to your particular case. This requires that a knee specialist perform a thorough assessment, make a diagnosis, review any appropriate imaging, and render appropriate treatment. After a small trial of therapy, your doctor should reassess your knee and objectively be able to measure markers of improvement. We also look subjectively at how the patient is feeling. Both of these will help to dictate or guide further knee treatment.
What are the different types of knee injuries?
Knee injuries can be divided several ways – acute, which implies an injury of six weeks or newer, or chronic, implying that the knee injury has been around for quite a while. But knee injuries can also be categorized as either cumulative through repetitive strain mechanisms, traumatic through an actual isolated event, or even degenerative as is the case with normal wear and tear as we age.
How long does it take for a knee injury to heal?
The typical inflammatory response after a new injury is six to eight weeks, but some knee injuries never truly heal. Take the example of degenerative joint disease which is another way of saying degenerative osteoarthritis. This is not a process that ever truly heals but we are able to manage the symptoms of it very well so that the patient can continue throughout their day-to-day life without much issue.
What is the most common knee injury?
In today’s day and age, degenerative osteoarthritis, otherwise known as degenerative joint disease, is the common knee injury, given our aging population.
Can a knee injury heal on its own?
Absolutely and often knee injuries do, in fact, heal on their own. In Alberta alone, there are some 140,000 knee injuries per year. Most of these heal without any intervention from any type of doctor.
What is the best thing to do for a knee injury?
Best practices for a knee injury involve cessation of any offending activity, icing the knee ten minutes on, ten minutes off times three, paying close attention to your symptoms and seeking help early. There is a difference between hurt and harm. We distinguish this often by the presence or absence of sharp pain and the presence or absence of limping or changing of your gait. If you have sharp pain or limping, your chances of creating harm increase. These are very reliable indicators that you should seek a knee specialist assessment.
When should you see a doctor for knee pain?
You should see a doctor for knee pain when it impacts your ability to perform your activities of daily living, when you have sharp pain, or when your knee pain causes you to limp or change the way that you perform your activities.
How do you get rid of knee pain fast?
Some of the most reliable approaches include icing your knee ten minutes on, ten minutes off times three, buying and wearing very good quality, well cushioned neutral running shoes, and consistently working to strengthen the muscles around your knee, ankle, foot and hip.
Is my knee pain arthritis?
There are different types of arthritis. Most commonly, people deal with osteoarthritis otherwise known as degenerative joint disease. Rarely people deal with autoimmune issues including rheumatoid arthritis. Degenerative joint disease is a normal part of aging but some of us wear our joints out faster than others due to traumatic events, excessive body weight, faulty mechanics, or just bad genes. Rheumatoid arthritis requires more timely assessment by a knee specialist while degenerative osteoarthritis can be seen when the symptoms become enough to warrant it.